血清AFP、CG、SF在原发性肝癌早期诊断和预后中的价值

The values of AFP,CG,and SF in diagnosis and prediction for early primary hepatic carcinoma

目的探讨AFP、CG和SF三种肿瘤标志物单独或联合检测在原发性肝癌早期诊断和预后中的价值。方法测定并分析我院2008年9月～2009年12月收治的45例原发性肝癌患者、31例良性肝肿瘤患者和30例健康体检者血清中AFP、CG和SF水平,并对术后原发性肝癌患者进行随访。结果原发性肝癌患者血清中AFP、CG和SF水平明显高于良性肝肿瘤患者和健康体检者(P<0.05)。单项检测中血清AFP的灵敏度最高,达79.65%,但其特异度(64.41%)低。联合检测AFP+CG+SF的特异性最高,达88.85%。肝癌Ⅲ期患者的AFP和CG水平显著高于Ⅰ或Ⅱ期患者(P<0.05)。肝癌患者术后1个月及3个月血清中AFP、CG较术前明显降低(P<0.05)。结论单项检测时AFP灵敏度最高,CG特异度最高;联合检测AFP+CG可以提高肝癌诊断的灵敏度,联合检测AFP+CG+SF可以提高肝癌诊断的特异度,AFP+CG对肝癌的治疗效果及预后判断更具有价值。

Objective To explore the values of serum tumor markers AFP,CG,and SF single or detection on clinical diagnosis and prediction for patients with early primary hepatic carcinoma （PHC）. combined Meth- ods Serum tumor markers AFP, CG, and SF in 45 patients with hepatocellular carcinoma （HCC） and in 31 patients with benign liver tumor, which hospitalized from Sept. 2008 to Dec. 2009, and in 30 cases of healthy people were detected and data analysis were performed. Those patients with PHC were followed up after opera- tion. Results The levels of AFP, CG, and SF in patients with PHC were significantly higher than those in patients with benign tumor and in healthy people （ P 〈0.05）. The detection of AFP alone had the highest sen- sitivity （79. 65%） among the three tumor markers for the patients with PHC, but had low specificity （64.41G）. The combined detection of AFP＋CG＋SF had the highest specificity （88.85%）. The serum levels of AFP and CG in patients at stage UI HCC were significantly higher than those at stage Ⅰ or Ⅱ （ P 〈0.05）. The levels of AFP and CG in patients with PHC in 1 month and 3 months after operation were lower than those before operation （ P 〈0.05）. Conclusion In single test, AFP and CG have the highest sensitivity and spe- cificity, respectively. But under combined detection of tumor markers, AFP＋CG can improve the diagnostic sensitivity, and AFP＋CG＋SF can improve the diagnostic specificity. AFP＋CG are valuable markers for eval- uating treatment effects and estimating prognosis.